KERRY DIANE WALLACE

GASTONIA, NC
NPI1932499498
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: NC  087186)
Enumeration Date2011-04-18
Last Update Date2011-04-18
Business Address
-- KERRY DIANE WALLACE CRNA
2525 COURT DR
GASTONIA, NC 28054-2140
Phone number: 704-834-4113
Mailing Address
-- KERRY DIANE WALLACE CRNA
1550 UNION RD STE B
GASTONIA, NC 28054-5522
Phone number: 704-864-8772
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